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Euphoria
Euphoria (pronunciation: /juːˈfɔːriə/) is an affective state and a form of pleasure in which a person experiences intense feelings of well-being, happiness, and excitement. Certain drugs, many of which are addictive, can cause euphoria, which at least partially motivates their recreational use.6 Similarly, certain natural rewards and social activities, such as aerobic exercise, laughter, listening to emotionally arousing music, music-making, and dancing, can induce a state of euphoria.57 Euphoria is also a symptom of certain neurological or neuropsychiatric disorders, such as mania.8 Romantic love and components of the human sexual response cycle are also associated with the induction of euphoria. Intense euphoria is believed to occur via the simultaneous activation of every hedonic hotspot within the brain's reward system. Types Many different types of stimuli can induce euphoria, including psychoactive drugs, natural rewards, and social activities. Affective disorders such as unipolar mania or bipolar disorder can involve euphoria as a symptom.8 Exercise-inducededit Main article: Neurobiological effects of physical exercise § Euphoria Runners can experience a euphoric state often called a "runner's high". Continuous physical exercise, particularly aerobic exercise, can induce a state of euphoria; for example, distance running is often associated with a "runner's high", which is a pronounced state of exercise-induced euphoria.13 Exercise is known to affect dopamine signaling in the nucleus accumbens, producing euphoria as a result, through increased biosynthesis of three particular neurochemicals: anandamide (an endocannabinoid),14 β-endorphin (an endogenous opioid),15 and phenethylamine (a trace amine and amphetamine analog).131617 Music euphoria Euphoria can occur as a result of dancing to music, music-making, and listening to emotionally arousing music.71819 Neuroimaging studies have demonstrated that the reward system plays a central role in mediating music-induced pleasure.1920 Pleasurable emotionally arousing music strongly increases dopamine neurotransmission in the dopaminergic pathways that project to the striatum (i.e., the mesolimbic pathway and nigrostriatal pathway).181920 Approximately 5% of the population experiences a phenomenon termed "musical anhedonia", in which individuals do not experience pleasure from listening to emotionally arousing music despite having the ability to perceive the intended emotion that is conveyed in passages of music.20 Drug-induced A large dose of methamphetaminecauses a drug-induced euphoria.21 A euphoriant is a type of psychoactive drug which tends to induce euphoria.2223 Most euphoriants are addictive drugs due to their reinforcing properties and ability to activate the brain's reward system.8 Stimulants Dopaminergic stimulants like amphetamine, methamphetamine, cocaine, MDMA, and methylphenidate are euphoriants.38 Nicotine is a parasympathetic stimulant that acts as a mild euphoriant in some people.8 Depressants Certain depressants can produce euphoria; some of the euphoriant drugs in this class include drinking alcohol (i.e., ethanol) in moderate doses,2425 γ-hydroxybutyric acid,3 and ketamine.3 Euphoria has also been noted to occur in a very small percentage of individuals who used pregabalin in controlled trials as a treatment for neuropathic pain associated with diabetic peripheral neuropathy.26 Some barbiturates and benzodiazepines may cause euphoria. Euphoriant effects are determined by the drug's speed of onset,27 increasing dose,28 and with intravenous administration.29 Barbiturates more likely to cause euphoria include amobarbital, secobarbital and pentobarbital.3031 Benzodiazepines more likely to cause euphoria are flunitrazepam, alprazolam and clonazepam.273233 Benzodiazepines also tend to enhance opioid-induced euphoria.34 Opioids µ-Opioid receptor agonists are a set of euphoriants8 that include drugs such as heroin, morphine, codeine, oxycodone, and methadone. By contrast, κ-opioid receptor agonists, like the endogenous neuropeptide''dynorphin'', are known to cause dysphoria,8 a mood state opposite to euphoria that involves feelings of profound discontent. Cannabinoids Cannabinoid receptor 1 agonists are a group of euphoriants that includes certain plant-based cannabinoids (e.g., THC from the cannabis plant), endogenous cannabinoids (e.g., anandamide), and synthetic cannabinoids.8 Inhalants Certain gasses, like nitrous oxide (N2O, aka "laughing gas"), can induce euphoria when inhaled.8 Glucocorticoids Acute exogenous glucocorticoid administration is known to produce euphoria, but this effect is not observed with long-term exposure.8 Asphyxia-induced Asphyxiation initially produces an extreme feeling of euphoria35 leading some people to intentionally induce temporary asphyxiation. Erotic asphyxiation typically employs strangulation to produce euphoria which enhances masturbation and orgasm.36 The choking game, prevalent in adolescents, uses brief hypoxia in the brain to achieve euphoria.3738 Strangulation, or hyperventilation followed by breath holding are commonly used to achieve the effects. Accidental deaths occur from both practices but are often mislabeled as suicide.394041 Neuropsychiatric Mania Euphoria is also strongly associated with both hypomania and mania, mental states characterized by a pathological heightening of mood, which may be either euphoric or irritable, in addition to other symptoms, such as pressured speech, flight of ideas, and grandiosity.4243 Although hypomania and mania are syndromes with multiple etiologies (that is, ones that may arise from any number of conditions), they are most commonly seen in bipolar disorder, a psychiatric illness characterized by alternating periods of mania and depression.4243 Epilepsy Brief euphoria may occur immediately before or during epileptic seizures originating in the temporal lobes or insulae.4445 This euphoria is symptomatic of a rare syndrome called ecstatic seizures, itself closely associated with religious and mystical experienceswhich are often euphoric. Euphoria (or more commonly dysphoria) may also occur in periods between such seizures. This condition, interictal dysphoric disorder, is considered an atypical affective disorder.46 Multiple sclerosis Euphoria sometimes occurs in persons with multiple sclerosis as the illness progresses. This euphoria is part of a syndrome originally called euphoria sclerotica, which typically includes disinhibition and other symptoms of cognitive and behavioral dysfunction.